Comparison of Effects of Active Recovery and Deep Water Running on Soccer PlayersÃÂ Indices of Muscular Damage Mohammad Sajadian*, Mohammadreza Kordi, Abassali Gaeiniand Nader Rahnama Faculty of Health Science, Department of Nursing, İzmir Kâtip Çelebi University, Çiğli- İzmir 35580, Turkey Corresponding Author: Mohammad Sajadian Department of Physical Education University of Tehran, Kish International Campus, Kish, Iran E-mail: firstname.lastname@example.org Abstract Introduction: The present research was aimed at comparison of effects of active recovery and deep water running on serum levels of Creatine Kinase (CK), Lactate Dehydrogenase (LDH) and, Aspartate Aminotransferases (AST) as indices of muscular damage subsequent to a simulated soccer game among 19-21 year old players of Ahwaz Naft soccer team present in premier league. Method: 18 players of Naft soccer team were randomly assigned to either of the two 9 membered groups of active recovery (AR) and deep water running (DWR). Afterwards, the aforementioned participants took part in a 90 minute (including two 45 minute rounds of random activity) simulated soccer activity that was primarily designed by Bangsbow (1991) and modified by Bishop et al., (1999). After the activity, one group was administered an active recovery while the other was administered deep water running recovery. In order to compare the changes of variables in the aforementioned groups, the statistical method of mixed variance analysis among subjects was used. Findings: The difference between changes of variables between the groups of AR and DWR was not statistically significant (P= 0.541, P= 115 and P= 748 respectively for LDH, CK and AST). Conclusion: It seems that there is no statistically significant difference between the effects of active recovery and deep water running recovery on muscular damages of soccer players after a period of playing. However still more research is required in this regard. Keywords Football; Recovery; Muscular bruising; Creatine kinase; Recovery in water Introduction During their training programs, and especially in periods prior to tournaments, soccer players do exercises with maximal intensity and in addition, they are also subjected to exhausting schedules during tournament seasons. On this basis, improper recovery subsequent to pressures of exercise and playing can lead to deterioration of players’ physical performance [1-2] resulting in projection of extraordinary and continued stress on their muscles [3,4]. One condition that may resultantly occur is muscle soreness which results in discomfort, pain and reduced physical performance. The pain due to delayed muscle soreness normally emerges between 12 to 24 hours after the activity and may remain for 2 to 5 days . One of mechanical elements of soreness may lie in damaging of sarcomeres in muscular structure which ultimately result in tearing of Z plates . Among the biochemical symptoms of delayed muscle soreness, it can be referred to an increase in levels of Creatine Kinase enzyme; with its serum levels increasing concurrent with tearing of sarcomeres . In addition, intense exercise is usually accompanied by an increase in the level of LDH enzyme . On the other hand, AST has been frequently considered as an indicator of muscular damage in various studies . In general, muscular damage is associated with release of AST, CPK and LDH enzymes . In other words, increased levels of CK, LDH and AST after intense exercise may result in increase in concentration of enzymes indicating muscular damage as well as occurrence of oxidative stress . As a result of influence of the phenomenon of muscle soreness and oxidative stress on physical performance and wellness status, both coaches and athletes seek suitable methods for overcoming this phenomenon. The process of recovery plays a significant role in sustaining athletic performance and preventing exhaustion among players . In this regard, active recovery is generally accepted as a series of light intrinsic activity after intense activities. It is believed that this type of recovery improves athletes’ recovery process . Compared the passive recovery, active recovery increases the intake of lactate [15,16]. Low intensity active recovery after exercises with high intensity can result in activation of Adrenocentrine and increased catecholamine concentration . On the other hand, among different recovery methods, recovery in water in different temperatures is highly reputed among athletes. Although that there are contradictory information in this context, but generally the method of recovery in water in widely applied for making vascular contraction after occurrence of severe muscular damages as well as progression of physiological and psychological recovery and reduction of muscular damages resulting from sports . As reported by some researchers, recovery in cold, warm and mixture of hot and cold waters results in increased pace of removal of Creatine Kinase from blood and also contraction of vessels resulting from recovering in cold water reduces the amount of pain and inflammation. In addition, this method decreases cellular necrosis, neutrophils’ immigration, cellular metabolism and pace of guidance of neural messages which resultantly results in reduction of damages . Roswell et al.,  performed a study in soccer players and reported that after playing four soccer matches in four days, cold water recovery resulted in reduction of exhaustion and muscular pain, but it doesn’t have any significant effects on performance, damages and muscular inflammation. Since there were no prior studies having elaborated on comparison of effects of two types of recovery namely as AR and DWR among soccer players, and considering the fact that soccer is the most popular sport in the world and that improvement of soccer players is highly important; the present study was aimed at comparison of effects of active recovery and deep water running on serum levels of CK, LDH and AST as indices of muscular damage subsequent to a period of simulated soccer activity among 19-21 year old players of Ahwaz Naft team present in premier league. Materials and Method This research is a semi-experimental study with a pretest-posttest design. A number of 18 players of Ahwaz Naft soccer team employed in premier league with a body mass index of between 19-24 KGs per square meter were selected as the participants of study. Afterwards, these 18 players have been assigned to either of the two 9 membered groups of AR and DWR. After selecting the subjects, they were asked to follow the researcher’s proposed program for two weeks. They were obliged to eat three normal daily meals between the hours of 7:30 to 8:30; 13 to 14 and 21 to 22. This was administered in order to homogenize participants in terms of sleeping and waking hours and times of eating food. Furthermore, the participants were recommended to eat only normal routine foods and avoid taking in any kind of supplement and or medication. They were nevertheless, asked to wake up between 7:30 and 8:30 and go to sleep at between 11 to 12 P.M. Nevertheless, 48 hours prior to execution of the proposed sporting protocol, participants made presence in Fajr Hotel of Ahwaz in order to be able to control their nutrition and sleeping cycles . For this reason necessary arrangements were made with the management of the Fajr Hotel for continued residence of participants and supplication of their meals. On the other hand, it should be mentioned that the sporting facility and swimming pool of Naft complex of Ahwaz were used for execution of proposed sporting protocol. Additionally, further arrangements were made with the sampling unit and laboratory unit of Shahid Tondgooyan hospital in order to have a sampler, centrifuge and freezer for storage of samples. A week prior to execution of the proposed protocol, the subjects were asked to make presence at sporting facility of Naft complex and after clarification of the goal and details of research, they were asked to fill in written consent forms. Afterwards, subjects’ height and weight were respectively measured with a height measurement device and a Germany made scale. In addition, BMI was calculated through dividing the square of height (meters) by weight (kilograms). On the day of execution of proposed sporting protocol, subjects of the both groups took part in a 90 minute (two 45 minute rounds) simulated soccer activity that was primarily developed by Bangsbow and later reformed by Bishop et al. The silhouette of this activity is similar to activities performed by professional soccer players including standing, walking, non-maximal intensity running and maximal intensity running. This protocol includes two rounds each including 45 minutes of activity with a 15 minute resting interval between each round. Each 45 minute round is divided into smaller sections. These sections include 7 periods of 2 minute activity including: 50 meters of ball dribbling between cones that are five meters away from each other, 50 meters of running backwards and 50 meters of walking. The remaining time at the end of each two minute section is considered as resting time. The total distance travelled during the whole 90 minutes of this test is approximately 10 kilometers which is similar to the distances reported players of English Premier League . After execution of the simulated soccer activity, one group was administered a recovery in deep water while the other group was administered an active recovery. The AR included 8 minutes of activity on dry land comprising of 8 minutes of juggling, 8 minutes of walking and back and forth running and 4 minutes of tensile movements [23,24]. On the other hand, DWR included 10 minutes of walking and tensile movements, 30 minutes of walking and running in deep water and 5 minutes of cooling down with more tensile movements . 5 ml of subjects’ blood was extracted from their arm vessel before activity, immediately after the activity, 24 hours after the activity and 48 hours and 72 hours after the activity. In order to separate the serums, the blood samples were centrifuged for 10 minutes at the speed of 2000RPMs after clotting. Until the time of measurement of variables, the samples were kept in a fridge at -20 degrees Celsius. Serum levels of CK, LDH and AST were measured for each sample using the Chlorometric method and the Germany made ROSCH device. In terms of statistical analyses, research data were first subjected to descriptive statistics and in this regard, the data were described according to standard deviations. Afterwards, the normality of data distribution was checked using the Shapiro-Wilk test and it was further manifested that data were normally distributed. On this basis, the mixed variance analysis method was used for comparison of changes in variables in two groups of AR and DWR through repetitive measurement in a 2×5 design. Results The mean and standard deviation values of the aforementioned two groups were measured at five different times and results are shown in Table 1. In addition, Table 2 includes the results of mixed variance analysis between the subjects of the two groups. Results have shown that the changes were statistically insignificant in all three variables of muscular damage indices between the two groups of active recovery and deep water running (P= 0.541, P= 115 and P= 748 respectively for LDH, CK and AST). 72 hours after activity 48 hours after activity 24 hours after activity Immediately after activity Before activity group variable 292/0 ± 449/5 488/0 ± 663/5 767/0 ± 418/5 458/0 ± 468/5 524/0 ± 371/5 DWR LDH(mg/l) 498/0 ± 558/4 488/0 ± 571/4 614/0 ± 519/4 272/0 ± 529/4 460/0 ± 377/4 AR 407/0 ± 498/3 246/0 ± 479/3 383/0 ± 316/3 287/0 ± 294/3 421/0 ± 277/3 DWR CK(mg/l) 544/0 ± 540/5 320/0 ± 417/5 524/0 ± 041/5 412/0 ± 5 753/0 ± 951/4 AR 186/0 ± 123/3 311/0 ± 116/3 395/0 ± 932/2 332/0 ± 771/2 389/0 ± 673/2 DWR AST(mg/l) 258/0 ± 564/1 197/0 ± 449/1 189/0 ± 547/1 193/0 ± 262/1 238/0 ± 210/1 AR Table 1: Mean and Standard deviation values of studied variables. Effect Size P F variable 047/0 541/0 782/0 LDH 122/0 115/0 232/2 CK 029/0 748/0 484/0 AST Table 2: Results of mixed variance analysis. Discussion The present study tried to compare the effects of active recovery and running in deep water subsequent to a period of simulated soccer activity on indices of muscular damage among soccer players. Results have shown that differences between changes in serum levels of CK, LDH and AST were not significant between the AR and DWR groups. Considering the fact that the muscular damage indices hadn’t significantly changed in none of the groups, it can be said that probably both types of recovery have beneficial effects on reduction of muscular damages subsequent to exercises and matches in soccer game. Although that there may not be a statistically significant difference between effects of these two types of recovery, still if the present study had also included a control group, we could have made more certain comments regarding the differential effects of the former and latter types of recovery. Soccer is a sport in which different physiological systems including the skeletal-muscular, the nervous, the immune and metabolism systems are involved. On this basis, making use of effective strategies regarding recovery until the next game is of high importance. Intense exercises and soccer games have been shown to weaken the immune system and cause metabolic disorders . Therefore, when soccer games are held with high intensity, it becomes more important to find suitable recovery methods . In this regard, results obtained by Watts et al., and Nikros show that active recovery has beneficial effects on indices of muscular damage [26,27]. Thy have shown that recovering back to the initial status is effective in terms of faster removal of lactate. CK and AST are among the assuring indices of permeability of the muscle membrane , because this enzyme is only found in heart and skeletal muscles. On this basis, deterioration of Z lines and damaging the Sarcolemma makes the infusion of enzymes of muscle such as CK into the inter-tissue water possible . Muscular tissues may be damaged due to metabolic, mechanical and or a mixture of both elements subsequent to intense exercises or games. Serum levels of enzymes and proteins of skeletal muscles are considered as symptoms of status of performance of muscular tissues and are highly different in every pathologic and or physiological condition. CK and DHT are the most applied serum symptoms of muscular damages which may change after intense physical activity . During intense activities, as a result of increased blood pressure, the fluids of the blood exceed the capillaries and enter active muscles. On the other hand, it has been reported that recovery in deep water can be a suitable substitution for regular recover methods in days after tournaments . Riley et al.,  have also reported that running in deep water results in decreased muscular pain. Porent et al., investigated the effects of recovery methods after a continuous and exhausting exercise on anaerobic performance 24 hours after the recovery period. They concluded that after exercising, anaerobic performance of the group floating in water was highly improved compared to one hour before and after exercising . In general, water has physical characteristics different than air and may reflect different physiological responses in a way that body’s heat transfer ability improves in water [33,34]. This issue may result in more desirable recovery in water environment compared to air. In addition, running in deep water can result in reduction of stress on skeletal muscles which ultimately results in reduced muscular damages . While floating, the pressure imposed by the water results in movements of fluids from the external-cellular spaces towards the inside of vessels and therefore, more blood is pumped into the muscles and resultantly, the body’s overall vascular return, heart output and blood flow are increased. Additionally, acceleration of return of fluids to blood flow not only results in faster disposal of wastes produced by body metabolism, but also results in reduction of muscular pain and soreness and improves performance as well [36,37]. However, the findings of the present study have not shown any statistically significant difference between these types of recovery. Increasing the sample size in a future study can yield more generalizable and precise results. However, a suitable recovery after exercising is dependent on various aspects including personal differences and lifestyles of individuals . During the week, soccer players undertake intense exercises and at the end of the week, they will hold an official match. These exercises and matches are continued during the whole season. In addition, in global or continental tournaments, players may have to attend 3 to four matches per week. All these result in exposure of athletes’ bodies to severe stresses and resultantly, their further or next performance would be deteriorated. It is recommended to do more studies containing larger sample sizes in addition to considering for a control group as well and while also measuring other variables related to tissue damages especially inflammatory elements and indices of oxidative stresses in order to be able to have a better understanding of finding better desirable recovery methods among soccer players. 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